How does integrated care fit the mission of my workplace?

Ultimately, the goals of behavioral health interventions are similar to those of other primary care treatment: We aim to help people function so they can lead healthier, fuller lives. Integrating behavioral health care into primary care settings allows psychologists to see patients at a faster pace and with higher efficiency. Psychologists are able to collaborate with physicians which enables physicians to be fully informed and control treatment recommendations, focuses assessment and evaluation, and allows for psychologists to be aware of physical health conditions that may affect mental health functioning. Further, psychologists rely on behavioral and cognitive-behavioral therapies as well as motivational interviewing, which are techniques that put the patient in the driver's seat and helps encourage their independence in changing their behaviors to better improve their personal health. Receiving both behavioral health and primary care treatment in one integrated setting helps to emphasize a community and public approach to health, which can help people continue to work or attend school, to engage with their families, to participate in their communities, and to be able to thrive.

Behavioral health psychologists recognize and appreciate the work ethic and values of primary care. Thus, behavioral health specialists are willing to adopt and adapt to the primary care culture and practice style through practicing flexibility, tolerance, selflessness and resiliency. We value clear, concise, timely communication and are interested in broad, contextual thinking within understanding and appreciating interdisciplinary systems of care. Behavioral health psychologists aim to use self- reflection and cultural sensitivity and humility to inform continuous self-improvement and professional development in different roles in the primary care setting. Behavior health specialists aim to understand and integrate the complexities of ethical, legal, professional, and practice standards of a team-based approach to the integration of psychology and primary care. Within this integration, psychologists and physicians are able to develop collaborative relationships with other professionals, work as a member of a team, and work to incorporate and understand evidence-based, patient-centered care from a team perspective.

What are the benefits of Integrated Care?

• Allows health care providers to coordinate patient diagnoses and treatments to complement each other and improve overall delivery and quality of care.
• Reduces likelihood of negative medication interactions and harmful effects of co-prescribed medications.
• Reduces the number of tests run and repetition of tests and procedures done for each patient.
• Promotes accessibility of patient information in one place, allowing providers to more easily monitor health conditions and coordinate treatments to reduce treatment interference.
• Reduces amount of paperwork patients must complete, thereby reducing error and confusion involved with paperwork.
• Reduces the stigma of receiving mental health care.
• Reduces practitioner burn-out.

What does integration look like?

• Telepsychiatry or consultative services
• Co-location of behavioral health and primary care services
• Embedded behavioral health team members within primary care

Overview of Behavioral Health Specialist Role and Responsibilities

Behavioral health specialists (BHS) have a wide breadth of knowledge that spans general health problems, common clinical health psychology problems, as well as child and family problems. General health problems may include generalized anxiety disorder, panic, post-traumatic stress, bereavement, mood disorders, eating disorders, substance misuse or abuse and somatization. Common clinical health psychology problems seen in a primary care setting may include chronic pain, diabetes, HIV/AIDS, obesity, hypertensions, sleep disorders, cardiovascular disease, sexual disorders, tobacco misuse or dependence, and women's health issues. BHS's also help with child and family problems such as developmental disorders, Autism spectrum disorder, ADHD, conduct disorders, learning disabilities, pediatric health, asthma, and family problems cause by parenting skills and relationship difficulties. These are only examples of the breadth of knowledge behavioral health specialist can receive referrals for. Make sure to consult with your resident behavioral health specialist about their areas of expertise, breadth of knowledge, and referrals that they accept.

Often, psychological roles are conceptualized as highly specialized, hour-long appointments with a single, couple, or family-based client. However, in the primary care setting, BHS's aim to use brief consulting or warm handoff session efficiently, usually within the same day as the patien's primary care appointment. They often see patients consecutively throughout the day, and aim to treat the patient's symptoms in four sessions or less. We often consult and collaborate with primary care providers to implement intermittent visits strategies and flexible patient contact strategies to best treat all of the patient's physical and mental health symptoms. BHS's are able to use brief consultation methods to triage a patient's mental health status and level of chemical dependency in order to better facilitate case management, referrals, and treatment recommendations. Flexibility is key within the primary care setting, and BHS's should be prepared to provide unscheduled services when needed, build and maintain relationships with all staff members, be available for on-demand phone consultations, and work to equalize the load carried by the professionals within the building.

As a part of the integrated team in a primary care settings BHS's understand the organizational mission, and the policies and procedures of the practice. They are trained to understand and apply risk management protocols, adhere to the ethical standards of the practice, and follow professional standards. Administratively, BHS's document patient referrals, treatment, and consultation in a timely way, and are trained and complete electronic health records and billing activities in a timely way.

Sources adapted from:

Robohm, J. (2014). Core characteristics of primary care ethics. Presentation: Getting started as a behavioral health consultant.

The work upon which this web site is based was funded through a grant awarded by the Montana Healthcare Foundation.

Disclaimer: The statements and conclusions on this site are those of the Grantee and not necessarily those of the Montana Healthcare Foundation. The Montana Healthcare Foundation makes no warranties, express or implied, and assumes no liability for the information contained on this site.